A Summary of the Third Asian and Oceanic Congress of Andrology

The Third Asian and Oceanic Congress of Androlo-gy was held on May 24-27, 2000, at Makuhari Messe,Chiba, Japan. The Congress Proper was preceded by aPost-graduate Course entitled "Operative Andrology". Inthe Course, doctors in leading positions gave lectures onthe advanced surgical technologies of andrology. A videounit was available that greatly assisted the participants toget hold of the new knowledge. The following surgicaltechniques were presented: MESA/TESE, vaso-vasosto-my and epididymo-vasostomy, microsurgical subinguinalvaricocelectomy, nerve-sparing retroperitoneal lymphnode dissection, and one-day penile prosthesis surgery. The Congress Proper started on the evening of May

An experimental study of colonic mucosal graft for urethral reconstruction

OBJECTIVE: To investigate the possibility of urethral reconstruction with a free colonic mucosal graft. METHODS: Ten female dogs underwent a procedure in which the urethral mucosa was totally removed and replaced with a free graft of colic mucosa. A urodynamic study was performed before the operation and sacrifice. The dogs were sacrificed 8 to 16 weeks after the operation for histological examination of the urethra. RESULTS: Urethral stricture developed in 1 dog. The results of urody namic studies showed that the difference in maximum urethral pressure between pre-operation and pre-sacrifice in the remaining 9 dogs was not of significance (P > 0.05). Histological examination revealed that the colonic free mucosa survived inside the urethral lumen of the 9 dogs. Plicae surface and unilaminar cylindric epithelium of the colonic mucosa was observed in dogs sacrificed 8 weeks after the operation. Plicae surface and unilaminar cylindric epithelium of the colonic mucosa was not observed and metaplastic transitional epithelium covered a large proportion of the urethral mucosa in dogs sacrificed 12 weeks after the operation. CONCLUSIONS: Urethral mucosa can be replaced by colonic mucosa without damaging the continence mechanism in female dogs. This technique is useful when local or preputial skin and buccal or bladder mucosa are not available.

Safety and efficacy of laser and cold knife urethrotomy for urethral stricture

Background Endoscopic treatment for urethral stricture, including cold knife and laser, poses a major challenge to clinical practice. Both the benefits and drawbacks of these two treatments remain controversial. This article aimed to compare the efficacy and safety of laser and cold knife urethrotomy for urethral stricture. Methods We searched PubMed （1966-2009）, Embase （1980-2009）, Cochrane Central Register of Controlled Trials （CCRCT, 2009 No.l） and Chinese Biomedical Literature Database （CBM） for laser and cold knife urethrotomy as treatment for male urethral stenosis, looking in the English literatures. Two reviewers independently screened the literatures and extracted information. Chi-square test was used for statistical analysis with SPSS15.0. Results A total of 44 articles, including of 3230 cases was retrieved. Success rate of patients treated with laser was 74.9% compared with 68.5% for cold knife, with very similar clinical results despite a statistically significant difference （P=-0.004）. The trend in success rate at a different follow-up time was similar between the two groups. No significant difference in success rate was found between the groups of repeat operation for recurrence cases, first P=0.090 and second P=0.459. The shorter the stricture length was （〈1 cm）, the higher the success rate was （P 〈0.0001）. No significant difference in success rate between the laser and cold knife groups was found in neither bulbar nor membranous urethra, bulbar P=0.660 and membranous P=0.477. The rates of urinary incontinence, urinary extravasation, and urinary tract infection showed no significant difference （P=-0.259, P=0.938, P=-0.653, respectively）. Conclusions Success rates for laser and cold knife were very similar despite being statistically different, with the groups having a similar trend in success rates at different follow-up time. Stricture location and history of endoscopic intervention did impact treatment outcome but was not significantly different. The two groups showed no significant difference in major complications.

Randomized clinical trial of a bladder neck plication stitch during robot-assisted radical prostatectomy

Urinary incontinence after robot-assisted radical prostatectomy （RARP） is one of the most bothersome complications affecting patients＇ daily lives. The efficacy of the bladder neck plication stitch technique in promoting an earlier return of continence was prospectively evaluated in 158 patients who underwent RARP for clinically localized prostate cancer by a single surgeon at our institute from March 2012 to January 2013. Patients were randomized 1：1 to undergo surgery with （n = 79） or without （n = 79） the bladder neck plication stitch, and their time to recovery from incontinence, defined as being pad free, was compared. Recovery from incontinence at 1, 3, and 6 months were observed in 22 （27.8%）, 42 （53.2%）, and 57 （72.2%） patients, respectively, treated with, and 23 （29.1%）, 47 （59.5%）, and 59 （74.7%） patients, respectively, treated without the bladder neck plication stitch, with no significant difference in time to recovery from incontinence between the two groups. Multivariate analysis showed that age, membranous urethral length and shape of the prostatic apex on magnetic resonance imaging were independent predictors of early recovery from urinary incontinence after RARP. The bladder neck plication stitch had no effect on time to recovery from postoperative urinary incontinence following RARR